Falls In Older Persons

Since the first edition of this very successful book was written to synthesise and review the enormous body of work covering falls in older people, there has been an even greater wealth of informative and promising studies designed to increase our understanding of risk factors and prevention strategies. This second edition, first published in 2007, is written in three parts: epidemiology, strategies for prevention, and future research directions. New material includes recent studies covering: balance studies using tripping, slipping and stepping paradigms; sensitivity and depth perception visual risk factors; neurophysiological research on automatic or reflex balance activities; and the roles of syncope, vitamin D, cataract surgery, health and safety education, and exercise programs. This edition will be an invaluable update for clinicians, physiotherapists, occupational therapists, nurses, researchers, and all those working in community, hospital and residential or rehabilitation aged care settings.

The WHO Falls Prevention for Active Ageing model provides an action plan for making progress in reducing the prevalence of falls in the older adult population. By building on the three pillars of falls prevention, the model proposes specific strategies for: 1. Building awareness of the importance of falls prevention and treatment; 2. Improving the assessment of individual, environmental, and societal factors that increase the likelihood of falls; and 3. For facilitating the design and implementation of culturally appropriate, evidence-based interventions that will significantly reduce the number of falls among older persons. The model provides strategies and solutions that will require the engagement of multiple sectors of society. It is dependent on and consistent with the vision articulated in the WHO Active Ageing Policy Framework. Although not all of the awareness, assessment, and intervention strategies identified in the model apply equally well in all regions of the world, there are significant evidence-based strategies that can be effectively implemented in all regions and cultures. The degree to which progress will be made depends on to the success in integrating falls prevention strategies into the overall health and social care agendas globally. In order to do this effectively, it is necessary to identify and implement culturally appropriate, evidence-based policies and procedures. This requires multi-sectoral, collaborations, strong commitment to public and professional education, interaction based on evidence drawn from a variety of traditional, complementary, and alternative sources. Although the understanding of the evidence-base is growing, there is much that is not yet understood. Thus, there is an urgent need for continued research in all areas of falls prevention and treatment in order to better understand the scope of the problem worldwide. In particular, more evidence of the cost-effectiveness of interconnections is needed to develop strategies that are most likely to be effective in specific setting and population sub-groups.

Despite of the enormous efforts of researchers and clinicians to understand the pathophysiology of falls in older adults and establish preventive treatments, there is still a significant gap in our understanding and treating of this challenging syndrome, particularly when we focus in cognitively impaired older adults. Falls in older adults are a very common yet complex medical event, being the fifth leading cause of death and a main cause of insidious disability and nursing home placement in our world aging population. Importantly, falls in the cognitively impaired double the prevalence of the cognitively normal, affecting up of 60% of older adults with low cognition and increasing the risk of injuries. The past decade has witnessed an explosion of new knowledge in the role of cognitive processes into the falls mechanisms. This was also accompanied with clinical trials assessing the effect of improving cognition via pharmacological and non-pharmacologic approaches to prevent falls and related injuries. Unfortunately, this revolution in emerging interventions left a gap between clinician-scientists and researchers at academic centers where the new data had been generated and the practitioners who care for cognitively impaired patients with falls. Most advances are published in specialty journals of geriatric medicine, neurology, and rehabilitation. The aim of this book is to reduce this gap and to provide practical tools for fall prevention in cognitively impaired populations. The proposed book is designed to present a comprehensive and state-of the-art update that covers the pathophysiology, epidemiology, and clinical presentation of falls in cognitively impaired older adults. We additionally aim to reduce the knowledge gap in the association between cognitive processes and falls for practitioners from a translational perspective: from research evidence to clinical approach. We will address gaps and areas of uncertainty but also we will provide practical evidence-based guidelines for the assessment, approach, and treatment of falls in the cognitively impaired populations. This book is a unique contribution to the field. Existing textbooks on fall prevention focus in global approaches and only tangentially address the cognitive component of falls and not purposely address special populations and/or settings as residential care and nursing homes. Due to the expected increase of proportion of older adults with cognitive and mobility impairments, this book is also valuable for the whole spectrum of the health care of the elderly. By including a transdisciplinary perspective from geriatric medicine, rehabilitation and physiotherapy medicine, cognitive neurology, and public health, this book will provide a practical and useful resource with wide applicability in falls assessment and prevention.

"In both hospitals and long-term care facilities it's the older patients and residents who are most prone to falling and most vulnerable to serious injury from a fall. Staff must constantly be on the alert for hazardous situations and know how to deal with falls. This easy-to-read guide provides just the right amount of information needed by health care staff to prevent and manage this common problem among older adults." "This book presents a wealth of practical recommendations, modifications, equipment, and resources that will improve the health and safety of older adult patients and long-term care residents."--BOOK JACKET.Title Summary field provided by Blackwell North America, Inc. All Rights Reserved

Covering epidemiology, evidence-based risk assessment and falls-prevention strategies, this book will be invaluable to all involved with health care of the elderly.

4. EVIDENCE-BASED BEST PREACTICES FOR THE PREVENTION OF FALLS: 4.1 Existing practice guidelines ; 4.2 Best practices for fall prevention ; 4.3 Selecting appropriate approaches according to setting; 4.4 Recovery from a fall ;4.5 Factors influencing client compliance in fall prevention . 5. SUPPORTING FALL PREVENTION STRATEGIES. 6. THE WAY FORWARD; References; List of tables and figures; Appendix A: Risk factors for falls and fall-related ; Appendix B: List of the Public Health Agency of Canada's resources on seniors' falls.

"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/